Protocol Increases Organ-Donation Options

Vanderbilt University Medical Center recently performed its third organ transplant in which organs were harvested from donors who were pronounced dead because of cardiac death. The new organ-procurement protocol differs from the longstanding practice of using an organ donor whose heart is still beating until the time the organs are harvested.

This new procedure for organ recovery and transplantation—called Donation After Cardiac Death (DCD)—offers promising options for families wanting to donate a loved one’s organs, and increases the availability  of donor organs desperately needed for transplantation. 

Vanderbilt’s three DCD donors have helped eight recipients receive a total of six kidney and two liver transplants.

With a growing number of patients on orga­­n-transplant waiting lists—estimates are nearly 100,000 in the U.S.—the United Network for Organ Sharing (UNOS) recently implemented DCD as another donation opportunity for families.

Dr. Beau Kelly
Dr. Beau Kelly

“Currently, 85 percent of organ donation is in the form of organs donated after patients have suffered a brain death,” says Dr. Beau Kelly, surgical director for the pediatric liver transplant program. “But now, donation after cardiac death is being offered as an option for families interested in organ 

donation. With donation after cardiac death, these people are not brain dead; rather, they have suffered an anoxic brain injury and are in a debilitated state … with no chance of recovery.”

Examples of such scenarios include heart attacks with low blood flow to the brain and high spinal-cord injuries from motor vehicle accidents. “In a donation after cardiac death, you are recovering those organs after the heart has stopped and there is no blood circulation. The need for recovery, therefore, is much more urgent.”

In both donation scenarios the families must initiate the request or process—either the patient has documented wishes or the family has decided to withdraw all care and support, Kelly explains.

“Families withdraw care and support from loved ones every day across the country, leaving the hospital only with a memory of the person they knew,” says Kelly. “But organ donation after withdrawal of care can give life to another person.”

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